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General NPI Number Information
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NPI Number | 1932376621
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Entity Type | Organization
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Legal Business Name | 1450 ASSOCIATES LLC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 1450 E CHESTNUT AVE BUILDING 4 SUITE A
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City | VINELAND
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State | NJ
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Zip | 08361-8467
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Country | US
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Telephone | 856-794-1700
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Fax | 856-794-1788
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Provider Business Mailing Address
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Address Line | 1450 E CHESTNUT AVE BUILDING 4 SUITE C
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City | VINELAND
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State | NJ
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Zip | 08361-8467
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Country | US
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Telephone | 856-794-1700
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Fax | 856-794-2671
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JOANNA BROWN
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Credential |
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Telephone | 856-794-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State | NJ
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